UTI in the Elderly and Care Homes

Nursing Homes Cut UTIs in Half Through a Focused Effort on Catheter Care
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Other Name: Theralogix: Theracran cranberry supplement, mg capsule. One mg cranberry capsule administered twice per day. Outcome Measures. Urine cultures were obtained at baseline and monthly for 6 months. Eligibility Criteria. Information from the National Library of Medicine Choosing to participate in a study is an important personal decision.

Urinary tract infection among older patients in the home care services

Contacts and Locations. Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please refer to this study by its ClinicalTrials. More Information. Feasibility of cranberry capsule administration and clean-catch urine collection in long-term care residents. J Am Geriatr Soc. UTI elderly prevention cranberry E. National Library of Medicine U. National Institutes of Health U.

Nursing Homes Cut UTIs in Half Through a Focused Effort on Catheter Care

Department of Health and Human Services. The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Urinary Tract Infection. Not Applicable.

Infect Control Hosp Epidemiol ; Urinary tract infections: how to manage nursing home patients with or without chronic catheterization. Infectious Disease ; 57 5. Optimizing antibiotics in residents of nursing homes: protocol of a randomized trial. BMC Health Services ; Clinical uncertainties in the approach to long term care residents with possible urinary tract infection.

Journal of the American Medical Directors Association ; 15 2 : The role of certified nursing assistants in the nursing home. JONA ; 33 11 : Journal of the American Geriatrics Society ; 61 1 : 62— Howe L. Education and empowerment of the nursing assistant: validating their important role in skincare and pressure ulcer prevention and demonstrating productivity enhancement and cost savings.

Cranberry for UTI Prevention in Residents of Long Term Care Facilities (PACS)

Adv Skin Wound Care ; Long-term care and oral health knowledge. JAMDA ; Weitzel T, Robinson SB. A model of nursing assistant care to promote functional status in hospitalized elders. Journal for nurses in staff development ;20 4 Enabling and empowering certified nursing assistants for quality dementia care.

International Journal of Geriatric Psychiatry ; Brief training to promote the use of less intrusive prompts by nursing assistants in a dementia care unit. Journal of Applied Behavior Analysis ;36 1 Slaughter, S. Incidence and predictors of excess disability among nursing home residents with middle-stage dementia: a prospective cohort study of functional transitions. Unpublished doctoral dissertation, University of Calgary, Alberta.

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Introduction Nursing home acquired pneumonia NHAP Long-term care LTC residents with cognitive impairment coPneumonia is the leading cause of death among nursing home residents 1 and the second most common infection 2 with reported incidences of between 0. Methods We utilized a pre-post, non-randomized, intervention trial design with HCAs and residents at three, comparable, long-term care facilities in Calgary, of which one site implemented the intervention and two maintained normal practices and procedures.

Urinary tract infection checklist for care homes

Educational Intervention HCAs in the intervention site were educated in informal, small group sessions by the designated RN educator. Data Collection Questionnaires were completed by HCAs at baseline, immediately post-intervention and 3 months later, to identify knowledge of UTI and NHAP symptoms, a 4-point Likert scale to measure their perceptions of the professional relationships between themselves and LPNs, and on workload.

Data Analysis Number of identified symptoms, and scores for each item on the relationship and workload questionnaires were compared across the three time-points using paired t-tests.

Results Rates of hospital transfer, length of stay and mortality were to low to include in the analysis. We analysed differences between the groups by using chi square test and analysis of variance ANOVA where bootstrap samples were chosen, as a normal distribution could not be ascribed to all variables.

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The analyses were performed using SPSS version We did a principal factor analysis of question 13 to reduce the many response alternatives to a manageable size. The questionnaire was sent to employees in the home care services, including registered nurses, assistant nurses, nursing students and assistants health personnel without formal nursing education , in six Norwegian municipalities.

A total of persons responded response rate Of the respondents 49 percent were registered nurses, 21 percent assistant nurses, 7 percent assistants, 3 percent department leaders and 20 percent nursing students. The registered nurses had worked on average 4. Table 1 shows what health personnel in the home care services consider to be the most important symptoms of UTI in their patients.

The symptoms are here ranked by what the nurses considered to be the most important compared to what the other professions considered the most important signs of UTI.

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For instance, 90 percent of the registered nurses considered confusion to be an important symptom of UTI, while 70 percent of the nursing students said the same. This shows that there was disagreement or different levels of knowledge as to how important these symptoms were. The results from question 4 see table 1 show that the great majority consider UTI to be their area of responsibility, and assistant nurses 34 percent , students 38 percent and assistants 90 percent contact a registered nurse and ask for assistance or advice as to how to proceed.

Half of the registered nurses state that they contact a physician, while the great majority excepting 40 percent of the assistants use a urine dipstick when they see signs of UTI in a patient.

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The number of personnel who collect a urine sample varies among personnel groups, but 67 percent of registered nurses say they collect a urine sample at symptoms of UTI. Question 5 maps practice for urine sample collection in the home care services. The results show that for all groups it is most common to let the patient urinate in a bedpan, plastic urine bag or urine container under supervision from 94 — percent table 1.

Some ask the patient to collect the urine; 41 percent of the registered nurses do this. The purpose of question 12 is to map practice for urine dipstick use. Table 2 shows the results from the factor analysis Analyses of the differences between the personnel groups on the four factors for urine sample handling showed that the registered nurses scored the highest on factor 1 no routines and factor 4 unsystematic practice statistically significant.

Assistants scored the highest on factor 2 random storage not significant , and assistant nurses scored the highest on factor 3 knowledge-based routines not significant. The figure shows that the registered nurses score the highest on knowledge-based routines.

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The result of question 7 showed that the registered nurses considered glucose 74 percent and protein 62 percent to be useful clinical indicators. The result of question 8 supports that the indicators are considered useful and that few registered nurses think that they should be removed glucose 34 percent, leukocytes 0 percent, nitrite 5 percent, protein 45 percent and blood 5 percent. The main reason for the uncertainty surrounding the reading of the urine dipstick is difficulties in distinguishing the colour nuances on the test strip from 30 — 80 percent table 1.

With regard to knowledge on important symptoms of UTI, the results from the questionnaire show that health personnel in the home care services have knowledge of the cardinal symptoms of UTI in the elderly.

Such cardinal symptoms include confusion, deterioration of general condition, painful urination, bad-smelling urine and frequent urination 3. Our study suggests that the level of knowledge varies among the personnel groups, especially when it comes to assessment of important symptoms such as deterioration of general condition, painful urination and bad-smelling urine.

The results also show that symptoms that may be considered vague, such as delirium, poor appetite, pain localised over the symphysis, apathy and anorexia are not considered important signs of UTI, even though they are considered possible symptoms of UTI in the elderly 3, For older patients signs of disease are typically vague and unclear 2, 3, 5.

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It is thus important that health personnel know that, for instance, poor appetite and apathy may also signal a somatic disease such as UTI. We believe that these results may indicate that health personnel in the home care services do not have enough knowledge that diffuse geriatric symptoms may be a sign of disease and functional decline.

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If this is the case it is cause for worry, especially as we know that health personnel in the home care services are frequently alone with the patients. They may be the only visitor to the patient that day. The patients depend on all personnel having basic competence to act adequately to give sufficient and appropriate help Elderly patients are often overdiagnosed and overtreated due to vague symptoms and high prevalence of asymptomatic bacteriuria. At the suspicion of UTI among older patients urine dipsticks are widely used 3 , which the results in our study also support.